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This is VAERS ID 283737

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

283737
VAERS Form:
Age:19.0
Gender:Female
Location:New Jersey
Vaccinated:2007-04-25
Onset:2007-04-28
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 UN / IM

Administered by: Private      Purchased by: Other
Symptoms: Rash pruritic

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: amoxicillin; hormonal contraceptives
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0705USA00465

Write-up:Information has been received from a registered nurse concerning a 19 year old female with pertinent medical history and drug reactions/allergies reported as none who on 25-APR-2007 was vaccinated with the first dose of Gardasil (lot #657621/03857U), 0.5 ml, IM. Concomitant therapy included amoxicillin and hormonal contraceptives (unspecified). On approximately 28-APR-2007 or 29-APR-2007 (nurse was not sure which date), the following weekend, the patient developed an itchy rash. The rash developed first on the patient''s arms and then on her legs. The patient sought unspecified medical attention. The patient took BENADRYL for the symptoms. There has been no improvement so the patient will be seeing a dermatologist. Additional information has been requested.


Changed on 9/14/2017

283737 Before After
VAERS Form:(blank) 1
Age:19.0
Gender:Female
Location:New Jersey
Vaccinated:2007-04-25
Onset:2007-04-28
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 1 UN / IM

Administered by: Private      Purchased by: Other
Symptoms: Rash pruritic

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: amoxicillin; hormonal contraceptives
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0705USA00465

Write-up:Information has been received from a registered nurse concerning a 19 year old female with pertinent medical history and drug reactions/allergies reported as none who on 25-APR-2007 was vaccinated with the first dose of Gardasil (lot #657621/03857U), 0.5 ml, IM. Concomitant therapy included amoxicillin and hormonal contraceptives (unspecified). On approximately 28-APR-2007 or 29-APR-2007 (nurse was not sure which date), the following weekend, the patient developed an itchy rash. The rash developed first on the patient''s arms and then on her legs. The patient sought unspecified medical attention. The patient took BENADRYL for the symptoms. There has been no improvement so the patient will be seeing a dermatologist. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=283737&WAYBACKHISTORY=ON


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